Why No HOfrust?

9:38 AM

Housemanship. The mere thought of it sends chills down (almost) every medical student's spine. It's often referred as hamba orang or other people's slave. In the hierarchy of the hospital housemen are regarded as the lowest of the lowest....that's what people say la.....including me. Has any one ever wondered why I was never HOfrust? Why lompat terus jadi MOfrust?

There are TWO main reasons:

Self explanatory
2. I wasn't really frustrated with my housemanship.

TWO years and SIX departments

Two years went by like nothing. I didn't feel too stressed out or frustrated during housemanship. I was fortunate for not getting extended in any of the departments. There were a few near misses but otherwise I sailed smoothly. Looking back, being a houseman was relatively easy. I didn't have to make any big decisions. All I needed to do was to listen carefully and attentively to what needed to be done during the ward rounds. Any problems that arises in the ward, I just consult with the MO in charge. There is a standard operating procedure (SOP) for almost everything, thus the importance of the sacred BOOK OF HOUSEMAN STUFF. Two other must have books are the Paediatric Protocol for Malaysian Hospitals and Sarawak Handbook of Medical Emergencies.

When patients get admitted to the ward:
1. Clerk and examine patient according to the SOP.
2. Document everything.
3. Take the necessary bloods and MAKE SURE they are sent and the lab results are traced as soon as possible.
4. Start basic management such as hydration, keep nil by mouth and insert Ryle's tube accordingly.
5. Inform MO in charge on your plans and what has been done.
6. Wait for MO or specialist to review together you.

In the morning, before ward rounds make sure all patients are reviewed and all previously planned procedures are done. Of course this has been over simplified. There's the regular occasions of complications and patients dying. But basically you JUST DO IT! (based on knowledge you learned in medical school). Anything happens housemen are still on probation. Getting extended in a posting is not as bad as getting hauled up to court. Just do things accordingly and safely, everything would be fine.


I am not sure how it is now but DURING MY TIME (I know you hate this phrase), the number of HO in a department can be really volatile. In one month, there would be 30 HOs in a department. Then in the next there can be only 12 remaining. When there are 30 HOs, it would be really lenggang kaki. There was once only 10 'functioning' HOs in medical department. EOD (every other day) and even back to back on calls for a month was the norm. I said 'functioning' because there will always be some moronic HO who would take emergency leave tak tentu pasal and gets away with it. For me, when each HO gets 3 to 5 on calls per month, an equilibrium has been achieved. If there are too many HOs in a department, there will be a 'Who Dunnit Syndrome':

"I thought that guy did it already. I passed it on to him"
"No la, where got. I thought boss told you to do it"

Everyone thought everyone was doing it and actually NO ONE did it.

Another reason I wasn't all stressed up during HOship was because I surround myself with great colleagues. Consider this; if you have problems with everyone in EVERY department you go to, what does it mean?
A. I am superior and everyone else just hates me for who I am
B. There is something wrong with me that needs changing

Unfortunately, I have met quite a few who answered (A). 

The key word here is to learn to GIVE AND TAKE. Housemanship can some times be difficult and you need all the help you can get. But to make others help you, you have to help others first. If it is 5 p.m. (time to punch out) and you see that  your colleagues who are on call left with a bunch of ward work, help out. Don't just pack your bags and leave. I have been very fortunate at times when some of my colleagues stay back to help out whenever I am on call. When you find these colleagues that can work with you as a team, keep them close because you can always count on them. I still value my colleagues who worked with me at Hospital Taiping. :)


Attitude plays a big role as well. If you want to sulk and complain about everything, HOship is definitely not for you. The most important attitude to have is to stay positive and be willing to learn as much as possible. There has been countless scenarios since I became an MO that I always tell myself:


When you are an MO, you walk alone. The Liverpool motto just don't apply when you're an MO. The HOship training ensures that the patient that visits your rundown district hospital in the middle of the night survives to see another day. If you didn't do your housemanship properly, you will be a goner in no time. 

The training might not be as Ultraman as it used to be (read here), but be like this particular HO from Ipoh.

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  1. Well written! I felt the same just like you, when I was there as HO. Unfortunately, when I became your MO I didn't have much time to teach, most of the time operating in OT. My punch never clocked at 5pm. Sometimes when I'm lucky it will clocked at 6pm. Overall, I still like the old hospital.


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